The University of Zimbabwe-University of California, San Francisco Collaborative Research Programme (UZUCSF), in collaboration with the University of California, San Francisco (UCSF), is the site of a well-established, large Clinical Trials Unit (CTU) with 4 Clinical Research Sites (CRSs), covering 6 distinct geographic locations within and surrounding Harare, Zimbabwe. Experience gained from leadership and participation in 4 Division of AIDS (DAIDS) Networks (HPTN, MTN, ACTG, IMPAACT), positions the CTU to continue its contribution to the global understanding of HIV epidemiology and pathogenesis by serving as a center of research excellence in the prevention and control of HIV and AIDS. Utilizing the expertise of our international and local complement of investigators and highly trained and experienced research personnel, the CTU will accomplish this through completion of the following Specific Aims: 1.a. Identifying, screening, enrolling, and retaining existing and new at-risk populations in an environment of declining prevalence and incidence, in the following mission-specific domains of scientific priority of the 4 future NIAID-sponsored Networks: i) Adult HIV Therapeutic Strategies, including HIV cure, noninfectious comorbidities, and the infectious co-morbidities of hepatitis and tuberculosis; ii) Strategies to Address HIV and HIV-associated Infections in Pediatric and Maternal Populations; iii) Integrated HIV Prevention Strategies; and iv) Microbicide Strategies to Prevent HIV infections, and 1.b. Contributing to the scientific leadership of the 4 future NIAID-sponsored Networks. 2. Utilizing an increasingly efficient and sophisticated centralized administrative structure to support the uninterrupted execution of protocols across 4 restructured CRSs, laboratory, and pharmacy components. 3. Leveraging the integral relationships developed with the CTU's community partners and diverse stakeholders to disseminate research findings and translate research results into evidence-based best practices and policies at the local, regional, and international levels. RELEVANCE: The CTU's implementation of protocols across the 4 Networks may produce results that translate to policies within Zimbabwe and internationally to reduce HIV incidence and prevalence. The CTU anticipates that this new evidence will further inform policies to reduce the Zimbabwean HIV incidence from its current 3% to 2%; reduce current HIV prevalence from 13% to 7.5%; reduce HIV vertical transmission from the current 14% to <5%; and reduce TB incidence from 633 per 100,000 persons to 200 per 100,000.